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Individual

DR. EMILY A MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
42 N SAINT JOSEPH AVE STE 100, NILES, MI 49120-2203
(269) 684-6696
Mailing address
42 N SAINT JOSEPH AVE STE 100, NILES, MI 49120-2203

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
02004694A
IN
208600000X
Surgery Physician
Primary
5101018742
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043537020
MI
01
PENDING
RAILROAD MEDICARE PIN
IN
05
PENDING
IN
Enumeration date
04/29/2010
Last updated
08/02/2024
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